Breier J I, Fuchs K L, Brookshire B L, Wheless J, Thomas A B, Constantinou J, Willmore L J
Department of Neurosurgery, Texas Comprehensive Epilepsy Program, University of Texas Health Science Center, Houston, USA.
Arch Neurol. 1998 May;55(5):660-5. doi: 10.1001/archneur.55.5.660.
To contrast and compare self-reported quality of life in patients with intractable epilepsy and pseudoseizures and to examine the relationship between self-reports and objective measures of cognitive functioning in both of these groups.
Case series using profile analysis and analysis of covariance.
University epilepsy surgery program.
Forty-three patients with intractable complex partial seizures of unilateral temporal lobe origin and 25 patients with pseudoseizures.
Quality of Life in Epilepsy Inventory-89; neuropsychological tests assessing verbal memory, nonverbal memory, naming, and attention; and the Depression Scale (2) of the MMPI-2 (Minnesota Multiphasic Personality Inventory).
Patients with pseudoseizures described themselves as more limited in the physical health domain than patients with complex partial seizures. Self-perceptions of cognitive functioning were similar between groups, despite the superior performance of patients with pseudoseizures on objective measures. Self-perception of cognitive dysfunction was related to mood disorder in the pseudoseizure group only, and there were no relationships between subjective and objective measurements of cognitive status within this group independent of mood disorder. For the complex partial seizures group, relationships between subjective and objective measures of cognitive function were dependent on the side of seizure onset.
Results are consistent with hypotheses that suggest that patients with pseudoseizures focus on physical rather than psychological explanations for stress, and that this focus is related, at least in a subgroup of patients, to mood disorder. Results also provide support for the validity of the Quality of Life in Epilepsy Inventory-89 in populations with intractable seizure disorder, although there is evidence for a possible floor effect on some of the subscales.
对比和比较难治性癫痫患者与假性癫痫患者自我报告的生活质量，并研究这两组患者自我报告与认知功能客观测量指标之间的关系。
采用轮廓分析和协方差分析的病例系列研究。
大学癫痫手术项目。
43例单侧颞叶起源的难治性复杂部分性发作患者和25例假性癫痫患者。
癫痫生活质量量表-89；评估言语记忆、非言语记忆、命名和注意力的神经心理学测试；以及明尼苏达多相人格调查表-2（MMPI-2）的抑郁量表（2）。
假性癫痫患者认为自己在身体健康领域比复杂部分性发作患者受到的限制更大。尽管假性癫痫患者在客观测量指标上表现更优，但两组患者对认知功能的自我认知相似。只有在假性癫痫组中，认知功能障碍的自我认知与情绪障碍有关，且在该组中，排除情绪障碍后，认知状态的主观和客观测量指标之间没有关系。对于复杂部分性发作组，认知功能主观和客观测量指标之间的关系取决于癫痫发作起始侧。
结果与以下假设一致，即假性癫痫患者将压力的原因更多地归结于身体而非心理因素，并且至少在部分患者亚组中，这种关注点与情绪障碍有关。结果还支持癫痫生活质量量表-89在难治性癫痫患者群体中的有效性，尽管有证据表明某些分量表可能存在地板效应。
